Trusts told to monitor use of safer surgery checklist

Many acute trusts could be failing to monitor the use of a mandatory patient safety tool, HSJ understands.

The World Health Organisation safer surgery checklist was developed in June 2008 and adapted for use in the NHS by the National Patient Safety Agency last year.

The investment of putting [the checklist] in place was dwarfed by the improvements

The agency set a deadline of this month for all acute trusts in England to start implementing the checklist - a set of pre-operative checks which aim to improve safety in operating theatres by focusing on better teamwork and communication.

A spokesperson for Patient Safety First said all acute trusts in England had begun implementing the checklist in time to meet the deadline.

However, latest research by the campaign found most acute trusts had no measures in place to monitor the use of the tool. In August and September 2009, a survey of all acute trusts in England found that just 13 per cent had measures in place to record that the checklist was being used and having an impact.

The worst offending regions were the South East Coast, East Midlands and the North East, where not one acute trust had procedures in place to measure how reliably the checklist was being completed, or for ensuring every member of the surgical team was involved in its use.

A spokesperson for NHS North East said improvements have been made since the audit was undertaken and that all acute trusts in the region were “very focused on working towards full use of the checklist as soon as possible”.

National clinical lead for perioperative care for the Patient Safety First campaign Mark Emerton, a Leeds Teaching Hospitals Trust consultant surgeon, said trusts needed to go further than just monitoring whether it was being used and measure tangible improvements in outcomes.

He said: “If this is to be more than just another “tickbox” exercise we must ensure implementation is done well and measurement of the improvements is an essential part of that process.”

Harvard Medical School associate professor of surgery Atul Gawande, who has used the checklist in the US, told HSJ trusts could make “significant savings” by implementing it.

He said in the eight hospitals where it was piloted globally complications had been reduced by a third.

“The investment of putting [the checklist] in place was dwarfed by the improvements, both in infection rates and other complications and in overruns [of operations] because of the costs they impose,” he added.